Country Report: Malaysia Akma Ngah Hamid Director Central Region Veterinary Laboratory (CRVL) Dpt. of Veterinary Service Introduction Antimicrobials are essential drugs and used in human and veterinary medicine to treat and prevent disease, and for other purposes including growth promotion in food-producing animals. However, using small amounts of antimicrobials over long period of time leads to the growth of bacteria that are resistant to the drugs effects, endangering humans who become infected but cannot be treated with routine antibiotic therapy. The more antimicrobials are used, the more likely antimicrobial resistant (AMR) to develop among pathogens and among commensal bacteria in an exposed population of animals. Antimicrobial resistance is a global public and animal health concern that is influenced by both human and non-human antimicrobial usage. This issue of AMR is now a significant health problem and each year in the European Union alone, over 25 000 people died from infections caused by antibiotic-resistant bacteria. Antibiotic resistance also posed problem in food safety where the use of antibiotic in food animals for treatment, disease prevention or growth promotion allow resistant bacteria and resistance genes to spread from food animals to humans through the food-chain (WHO, 2011). Organisation of the department of veterinary services The Department of Veterinary Services (DVS) is a Federal Government agency under the Ministry of Agriculture Malaysia. The DVS functions are documented in Minister Function Act 1969 and are as follows: i. To control, prevent, and eradicate animal and zoonotic diseases. ii. To promote the growth and development of livestock, livestock products, and animal feed productions. iii. Inspection of meat, milk, eggs, animal feed, abattoirs and animal based processing plants. iv. To control importation / exportation of animals, animal produce and quarantine. v. To provide training for livestock and pets industries. vi. vii. viii. To promote the growth and development of livestock production, animal health and veterinary public health. To promote research on animal diseases and animal genetic resources. To ensure the welfare of all animals and conservation of animal genetic substances. 1
The function of DVS listed in no. iii and no. iv indicate that livestock, livestock products and livestock based products are under DVS jurisdiction (inspections and supervisions). Beside domestic products, DVS also deal with importation products especially livestock based products and livestock products. It is important for DVS to design import control safety system to monitor the incoming products from importing country to Malaysia. Being a Muslim majority population in Malaysia, the Muslim consumers expect not only safe and quality food imported or produced, but also halal (prepared according to Islamic rites). Food safety and quality programs conducted by DVS are focusing on a farm-to-table approach, in order to eliminate or reduce food-borne hazards. This holistic approach was focusing on the control of food-related risks which involves control of every step in the chain, from raw material to food consumption. With regards to this holistic approach, the Department of Veterinary Services (DVS) conducted a certification programs, inspections and accreditation system as well as implementation of legislation to support Malaysia food safety and quality management system. The Livestock Farm Practices Scheme (SALT) was introduced by the DVS in 2003 on Good Animal Husbandry Practices (GAVP). The objective of SALT is to ensure the production of safe and wholesome food from farms practicing GAHP, operated in a sustainable and environmental friendly conditions and yield produces that are of good quality and safe for consumption. The SALT recognition is in the form of certificate and logo. To be certified, the farm must comply with the SALT requirements stated by the DVS. The SALT logo is a mark of quality given to livestock farms awarded under the Veterinary Inspection and Accreditation Programme of the Department of Veterinary Services, Ministry of Agriculture Malaysia. The criteria for the certification of SALT are based on GAHP, Animal Health Management, Bio-security, good infrastructure and prudent use of drugs. This Scheme covers all types of livestock such as beef cattle, dairy cattle, broiler chicken, layer chicken, breeder chicken, deer, goat, sheep and pig. Table 1 showed the organisation chart of DVS Malaysia. Table 1. Organisation Chart of Department of Veterinary Services, Malaysia 2
Usage of antimicrobial in the livestock There are 97 different type of antimicrobials registered with the National Pharmaceutical Control Bureau Ministry of Health, Malaysia (NPCB, MOH). Most of the registered drugs are used in poultry and pig farm and less in cattle and goat farm. Table 2 showed some of the group of veterinary drug which is registered with NPCB. Table 2. Registered antimicrobials for use in livestock Group of Drug Active Ingredient No. of Products β-lactam Ampicillin, Amoxycillin 8 Cephalosporins Ceftiofur, Cefadroxil Cefadroxil 3 Tetracycline Chlortetracycline, Oxytetracycycline, Doxycycline 13 Sulphonamide Sulfamethazine, Sulfadiazine, Sulfachloropyrazine, Sulfadimethoxine, Sulfaquinoxaline 8 Macrolide Tylosin, Erythromycin, Spiramycin, Tylvalosin 10 Aminoglycoside Neomycin, Gentamicin 2 Fluoroquinolone Flumequine, Enrofloxacin 8 Monitoring program of antimicrobial residues Monitoring of veterinary drug residue in food of animal origin are based on the number of animal slaughtered from the previous year and the species of animals. In Malaysia, monitoring of antimicrobials are based on EEC Directive 1990 and also on the capability of the laboratory to conduct the test. Currently the capabilities of the Veterinary Public Health Laboratory (MKAV/DVS) are limited to Group A5, A6, B1 and B3. Some of substances in other group are under development of the test method such as stilbenes. Table 3 shows the routine monitoring of veterinary drug which is carried out in the livestock. For monitoring of the antimicrobial Group B list, agar diffusion technique is used as a screening method whereas for antimicrobial Group A list, HPLC or LCMS-MS is used. If antimicrobial Group B list was found positive, the sample will proceed for further confirmation using HPLC or LC MS-MS. 3
Table 3. Monitoring of veterinary drug in Malaysia - Group of antimicrobial, substances, technique and matrix/species of livestock Group of Antimicrobial Substances Technique Matrix / Species Sulphonamide, Tetracycline, - Microbiology - Six Plate Test Pig, Milk, Egg Aminoglycoside, Macrolide, Quinolone β-lactam - Five Plate Test Tetracycline OTC, TC, CTC, DC, 4-eCTC HPLC Pig Sulphonamide SDZ, STZ, SP, SMERZ, SMZ, SMT, SIN, SMOPZ HPLC Pig Quinolone Sarafloxacin, Difloxacin, Ofloxacin, Enrofloxaxin, LC-MS-MS Pig Danofloxacin, Ciprofloxacin, Norfloxacin Kloramfenikol (CAP) CAP LC-MS-MS Pig, Milk, Egg Nitrofuran Nitrofurazone, Furazolidone, Furaltadone, Nitrofurantoin LC-MS-MS Pig, Milk, Egg Beta-agonist Brombuterol, Cimaterol, Cimbuterol, Clenpenterol, Clenbuterol, OH -methyl Clenbuterol, Isoxuprine, Mabuterol, Mapenterol, Ractopamine, Salbutamol, Terbutaline, Tulobuterol, Zilpaterol LC-MS-MS Pig Monitoring of veterinary drug residues in animal feed in Malaysia will be implemented in year 2013 according to the Animal Feed Act 2009. Sampling plan, number and type of feed sample, type of testing, feed millers, importers and distributors will be identified and monitored based on the Act. Table 4 shows the frequency and sampling plan for the monitoring of veterinary drugs in Malaysia according to the species of livestock. Table 5 showed the percentage of samples tested, number of sample, number of slaughter houses or processing plants for the Group A list which is banned and not allowed to be used in food-producing animal including Chloramphenicol, Nitrofurans and Beta agonists (NPCB, MOH 2009). Table 6 showed the percentage of samples tested, number of samples, number of slaughter houses or processing plants for the Group B list which is allowed to be used in food-producing but MRL shall be followed. 4
Table 4. Yearly monitoring of veterinary drugs in Malaysia Species of animal Percentage or number of samples a Group of substances Group A b Group B c Poultry/Duck 1 sample for every 200 tonne or 100 50% 50% sample for each group of substances Bovine 0.4% 0.25% 0.15% Porcine 0.05% 0.02% 0.03% Goat/Sheep 0.05% 0.01% 0.04% a. based on the number of livestock slaughtered from the previous year b. banned drug (Nitrofurans, Beta agonist, Rectopamine, Chloramphenicol, Steroid) c. drug which has MRL (Tetracyline, Sulfa and Contaminants such as Pesticide, Heavy Metal, Mycotoxin) Table 5. Yearly monitoring of banned drugs in Malaysia Species of animal Poultry/Duck Bovine Porcine Goat/Sheep Group of substances Number of Slaughter Houses Percentage or number of sample Number of samples collected 144 Chloramphenicol 1 sample/ per Nitrofurans 21 200 tonne of 144 Beta-Agonist production 125 Chloramphenicol Nitrofurans 30 0.25 60 Beta-Agonist 60 Chloramphenicol Nitrofurans 6 0.02 24 Beta-Agonist 24 Chloramphenicol Nitrofurans 0.01 59 Beta-Agonist 59 60 24 59 Species of animal Table 6. Yearly monitoring of antimicrobial residues (MRL) Group of substances Number of slaughter house Poultry/Duck Antimicrobial 21 Percentage of sample 1 sample/ per 200 tonne of production Number of samples Bovine Antimicrobial 30 0.15 90 Porcine Antimicrobial 6 0.03 59 Goat/Sheep Antimicrobial 29 0.04 59 675 5
Pattern of AMR in animal pathogens The human, animal and plant sectors have a shared responsibility to prevent or minimise AMR on both human and non-human pathogens. Veterinary drug residue in food of animal origin and antimicrobial resistance are two main problems if veterinary drugs are not properly managed in animal production. Most of the problems related to drug residue and drug resistance occurred or start at animal production level, where the usage of veterinary drugs are not properly managed and withdrawal periods are not monitored. Hence, management of veterinary drugs in animal production is a proactive program to control veterinary drugs usage and prudent use of veterinary drug to prevent the occurrence of veterinary drug residue in food and also antimicrobial resistance. Preliminary study of AMR in 2012 was carried out on both food-producing animals and foods. Different strains of Salmonella species and Disk Agar Diffusion Method was used in this study. AMR Salmonella in food-producing animals Thirty eight (38) isolates of different species of Salmonella is isolated from chicken cloacal swab were used for Antimicrobial Susceptibility testing. Cloacal swabs were collected from the poultry farm which is supervised under SALT programme. The poultry farm involved in this study is located at the central zone of Malaysia which consists of 4 states. Figure 1 and Figure 2 show the AMR Salmonella in chicken. From this study, 13.5% of Salmonella were resistant to Tetracycline, 5.4% Polymixin B and Erythromycin, and 2.7% to Chloramphenicol, Penicillin G and Trimethoprim. Figure 1. AM susceptibility of Salmonella isolates from chicken 6
AMR Salmonella in food Figure 2. AMR in Salmonella isolates from chicken Forty three (43) isolates of difference species of Salmonella was tested. The salmonella pathogen was isolated from 43 samples of food samples such as beef, mutton and chicken. About 62.8% of salmonella (27/43) was isolated from the imported products (44.2% beef and 18.6% chicken). Figure 3 shows the AMR Salmonella in the 43 isolates whereas Figure 4 shows the AMR in the imported beef, imported chicken and domestic chicken (25.6%). Figure 3. AMR Salmonella isolates from food 7
Figure 4. AMR Salmonella in domestic chicken, imported chicken and imported beef References National Pharmaceutical Control Bureau Ministry of Health, Malaysia (2009). Registration Guideline of Veterinary Products (REGOVP); Version 2, March 2009. WHO (2011). Tackling antibiotic resistance from a food safety perspective in Europe, World Health Organization, Geneva, 2011. 8